Doctors - to get €30 a phonecall from Govt.

ahnowbrowncow

Seth Brundle wrote: »

Aah would you stop!
Everything will be documented and many of the call details will be forwarded onto the HSE anyhow.
Thus thread should really be in the Conspiracy Theories forum :rolleyes:

Plenty of doctors, consultants etc have been in the tax defaulters list for tax evasion, i.e. underclaring income, overdeclaring expenses.

And you think that some of them won't fabricate some phonecalls? You're very naive.

And I also like that you think anyone who doesn't share your opinion is a conspiracy theorist, how open minded.

fryup

so what's to stop a unscrupulous doctor from getting all his family & mates from phoning him 24/7 ??

Charles Babbage

I'd say your average GP if asked if they would rather an end to this pox and so no €30 wouldn't take long to decide.

Balf

Balmed Out wrote: »

That may be true for some but not all. Plenty of areas of rural Ireland that find it difficult to get gp's because its not profitable enough, they still ne mmed to pay staff, rent, utilities etc. I think 30 is high but a payment is necessary.

Its the choice of the IMO that GP practices remain as private businesses, so I think you can guess the balance of advantage.

And they already get fully paid to serve the medical card holders, which provides most of their income.

beggars_bush

Then go off and study to become a doctor...

noodler

ahnowbrowncow wrote: »

Plenty of doctors, consultants etc have been in the tax defaulters list for tax evasion, i.e. underclaring income, overdeclaring expenses.

And you think that some of them won't fabricate some phonecalls? You're very naive.

And I also like that you think anyone who doesn't share your opinion is a conspiracy theorist, how open minded.

Tracking will be an issue.

Even getting the details of the patient in question on file it is difficult to see what checks can be done.

This will be paid per visit rather than the way paymenta for GMS or GPVC are done.

There will be surely be an incentive if incomes have really dropped.

That being said, it won't be a forever measure.

Geuze

italodisco wrote: »

50 to 70 for a gp visit, 30 over the phone is alot cheaper.

I'd love to know what gp's get from the gov for each medical card holder that visits for a head cold etc

It's a fee per GMS patient per year.

Depends on gender and age of patient.

Roughly 180 pa per patient.

noodler

beggars_bush wrote: »

Then go off and study to become a doctor...

No, we'll discuss the proper spending of public resources.

Thanks though.



On a side note, I'm a bit confused by some GPs saying their income has collapsed and yet they seem to be busy as hell.

Implies only cardholders are going and they are.going alot.

thomasdylan

noodler wrote: »

It's alot more than 100 euro!

It depends on the age of the patient but safe to say even the lowest age bracket is alot.more.than 100 euro annually.

Not true. For example it's €55.26 for males between 16 and 45.

noodler

thomasdylan wrote: »

Not true. For example it's €55.26 for males between 16 and 45.

I'm looking at a range between 150 and 500 for the most elderly patients

Balf

noodler wrote: »

It's alot more than 100 euro!

It depends on the age of the patient but safe to say even the lowest age bracket is alot.more.than 100 euro annually.

I'm not sure that's right - but open to correction.

They get a few hundred for elderly patients. But not for most people, in my understanding.

However, I think the main point is they are already paid to serve about half the population, which generates more than half their income.

noodler

Balf wrote: »

I'm not sure that's right - but open to correction.

They get a few hundred for elderly patients. But not for most people, in my understanding.

However, I think the main point is they are already paid to serve about half the population, which generates more than half their income.

This where I'm getting it.

http://budget.gov.ie/Budgets/2020/Documents/Budget/Costing%20Framework%20for%20the%20Expansion%20of%20GP%20Care%20(A).pdf

Page 14


I appreciate your point about the elderly but over 70s all have free GP cards regardless of income so nearly everyone in that cohort qualifies.

Balf

noodler wrote: »

No, we'll discuss the proper spending of public resources.

Thanks though.



On a side note, I'm a bit confused by some GPs saying their income has collapsed and yet they seem to be busy as hell.

Implies only cardholders are going and they are.going alot.

It sounds like complete nonsense, on which the GPs should be challenged.

Private income is the lesser part of their earnings.

thomasdylan

noodler wrote: »

I'm looking at a range between 150 and 500 for the most elderly patients

You were wrong so weren't you? You're misrepresenting/lying about capitation fees.

noodler

thomasdylan wrote: »

You were wrong so weren't you? You're misrepresenting/lying about capitation fees.

The highest payment is E434 for those over 70 in nursing homes.

It's E110 for males between 45 and 65, E121 for females between 45 and 65, E116 and E129 for males and females between 65 and 70. And e270 for those over 70.

Scroll up, I've a source for 150-500.

Lying? Jesus Christ.

Also, capitation coats only make up just over half of all GP fees and allowances. What I've linked.to is an average of the capitation fee and the ancillaries i.e. the full cost to the state of the average visit to a GP for a GPVC holder.

Wesser

Calls take a minimum of 15 to 20 mins each. By the time you take a history.... grt th e back ground.... log onto thr online website to request yhe test (website is going extremely slowly due to demand) explain re self isolation and what to do if deteriorating... followup on the results of the test. Give general advice... explore mental health issues.....

Balf

noodler wrote: »

This where I'm getting it.

http://budget.gov.ie/Budgets/2020/Documents/Budget/Costing%20Framework%20for%20the%20Expansion%20of%20GP%20Care%20(A).pdf

Page 14


I appreciate your point about the elderly but over 70s all have free GP cards regardless of income so nearly everyone in that cohort qualifies.

I see.

I think its actually pages 30 and 31 that you need to look at. Some of the capitation rates are below €100. The table you are looking add apportions all State payments to GPs. €200m of those payments are not capitation.

Only a technical point. The main point is GPs are already paid by the State, substantially.

noodler

Balf wrote: »

I see.

I think its actually pages 30 and 31 that you need to look at. Some of the capitation rates are below €100. The table you are looking add apportions all State payments to GPs. €200m of those payments are not capitation.

They are payments to GPs in totality.

The Capitation Rate is indeed the base payment bit there are another 40% depending on the specific patient.

The average cost of a visit for those covered the state is indeed between 150-500.

thomasdylan

noodler wrote: »

Scroll up, I've a source for 150-500.

Lying? Jesus Christ.

Also, capitation coats only make up just over half of all GP fees and allowances. What I've linked.to is an average of the capitation fee and the ancillaries i.e. the full cost to the state of the average visit to a GP for a GPVC holder.

Correct fees as of January 2020 are here:

https://www.hse.ie/eng/about/who/gmscontracts/2019agreement/circular-capitation-increases-nco-03-2020.pdf

noodler

thomasdylan wrote: »

Correct fees as of January 2020 are here:

https://www.hse.ie/eng/about/who/gmscontracts/2019agreement/circular-capitation-increases-nco-03-2020.pdf

They are updated alright. Increases in Capitation as a result of the new contract.

So the average cost of a GP visit card to the state is actually higher than the 150-500 I linked to as that was based on the pre-contract increase rates.

normanoffside

GP's have to rent a premise, provide a reception, secreatry, nurses, toilets and only afterwards take their own salary. I've been in GP surgeries that provide all those facilities but only charge €50/€60 for a consultaion which can last up to 1 hour at times.

For obvious reasons they cannot take suspected virus carriers into their surgeries but how can you expect them to provide this service for free?

It's a good move and money well spent IMO.

Bubbaclaus

Wesser wrote: »

Calls take a minimum of 15 to 20 mins each. By the time you take a history.... grt th e back ground.... log onto thr online website to request yhe test (website is going extremely slowly due to demand) explain re self isolation and what to do if deteriorating... followup on the results of the test. Give general advice... explore mental health issues.....

No no...sure according to a few clowns on this thread it's only a few questions and a chat.

noodler

normanoffside wrote: »

GP's have to rent a premise, provide a reception, secreatry, nurses, toilets and only afterwards take their own salary. I've been in GP surgeries that provide all those facilities but only charge €50/€60 for a consultaion which can last up to 1 hour at times.

For obvious reasons they cannot take suspected virus carriers into their surgeries but how can you expect them to provide this service for free?

It's a good move and money well spent IMO.

Fair enough.

I guess it's all open to debate.

I visited a GP last week for an unrelated issue. The consultation lasted no more than three minutes and cost 60 euro.

I would think alot of people would find the length of their consultation much closer to that than the hour extreme example you mentioned.

Anyway, I think It's less than consultation in the practice for 75 euro that is the issue.of.discussion here, more the 30 for the phone triage.

Bubbaclaus

noodler wrote: »

Fair enough.

I guess it's all open to debate.

I visited a GP last week for an unrelated issue. The consultation lasted no more than three minutes and cost 60 euro.

I would think alot of people would find the length of their consultation much closer to that than the hour extreme example you mentioned.

Anyway, I think It's less than consultation in the practice for 75 euro that is the issue.of.discussion here, more the 30 for the phone triage.

Would you find it better if the GPs refused to do it over the phone and asked everyone to come in? I dont understand the logic of it suddenly being cheaper than a normal consultation purely because it's over the phone?

Is buying your groceries from tesco online cheaper than doing it in person or something?

Balf

normanoffside wrote: »

GP's have to rent a premise, provide a reception, secreatry, nurses, toilets and only afterwards take their own salary. I've been in GP surgeries that provide all those facilities but only charge €50/€60 for a consultaion which can last up to 1 hour at times.

They get practice allowances paid by HSE in respect of the secretary and nurses, in proportion to the size of practice.

The consultation fee is extras income they can charge for private patients.

And, all the time, bear in mind it is the doctors who demand their own status as private contractors. It would suit the HSE more if GPs just worked out of HSE primary care centres, where they could integrate with public health nurses and other community health professionals.

Sleeper12

I think the last two FG governments were terrible but even I can see that the government paying the doctors is a good idea.

If patients thought they would be charged anything many would put off phoning the doctors. This in turn would leave more undiagnosed people with the virus.

Let's be clear here. Doctors surgery's and even pharmacy's are inundated with calls every day due to the virus. They are very time consuming. It isn't just a two minute call. There are many follow up calls.

It is what it is. We definitely can't let money stand in the way of battling the virus.

I think the government have made many mistakes on handling this crisis but this definitely isn't one of the mistakes imo

noodler

Bubbaclaus wrote: »

Would you find it better if the GPs refused to do it over the phone and asked everyone to come in? I dont understand the logic of it suddenly being cheaper than a normal consultation purely because it's over the phone?

Is buying your groceries from tesco online cheaper than doing it in person or something?

I absolutely see it as being cheaper than a walk in consultation.

1. It's a set issue with two primary symptoms, without which, we are told, you almost certainly won't be deemed as requiring a walk in consultation.

2. It's a set questionnaire.

3. How can a phone call take longer than a walk-in which could be about any condition?

4. Alot of the costs usually cited as being associated with running the practice aren't utilised (facilities etc).

5. There is.no risk to the GP or staff from the phone consultation.

EDIT: alot of repetition in the above. Apologies.

If a GP comes on here and tells me the phone triages have been talking 15 minutes (way longer than any actual consultation I've ever had) then I'll listen. But.to reiterate, 30 quid sounds high and it sounds like the State is once more stepping in to fill a hole because it is claimed private income has fallen.

I don't think they should necessarily do it for free.

ChikiChiki

Salary Negotiator wrote: »

They should do it for free?

30 euro is too much. An average call probably lasts about 10 - 15 minutes.

It's a national call to service here. All hands on deck.

That means, enough people, prudent spending of national finances etc.

Bubbaclaus

noodler wrote: »

I absolutely see it as being cheaper than a walk in consultation.

1. It's a set issue with two primary symptoms, without which, we are told, you almost certainly won't be deemed as requiring a walk in consultation.

2. It's a set questionnaire.

3. How can a phone call take longer than a walk-in which could be about any condition?

4. Alot of the costs usually cited as being associated with running the practice aren't utilised (facilities etc).

5. There is.no risk to the GP or staff from the phone consultation.

EDIT: alot of repetition in the above. Apologies.

If a GP comes on here and tells me the phone triages have been talking 15 minutes (way longer than any actual consultation I've ever had) then I'll listen. But.to reiterate, 30 quid sounds high and it sounds like the State is once more stepping in to fill a hole because it is claimed private income has fallen.

I don't think they should necessarily do it for free.

My work charges clients 360 euro an hour for my time and I am nowhere near as qualified as a GP. Even if the call took 5 minutes (which it does not), 30 euro is cheap.

A call would also take just as long if not longer than a face to face consultation, as you have to go through questions that you wouldn't normally have to in person as you could simply check breathing etc. Beats me how you think the patient not being there actually makes things quicker and easier. How does that make sense? An actual logic fail on your behalf.

It takes 9 years to train to be a GP and you are questioning a small 30 euro fee for their time. It's actually hilarious.

You might be able to hire a solicitor for about 3 minutes for 30 euro.

Bubbaclaus

ChikiChiki wrote: »

30 euro is too much. An average call probably lasts about 10 - 15 minutes.

It's a national call to service here. All hands on deck.

That means, enough people, prudent spending of national finances etc.

How much would you value 10-15 minutes of a doctors time to be? Just curious.

noodler

Bubbaclaus wrote: »

My work charges clients 360 euro an hour for my time and I am nowhere near as qualified as a GP. Even if the call took 5 minutes (which it does not), 30 euro is cheap.

A call would also take just as long if not longer than a face to face consultation, as you have to go through questions that you wouldn't normally have to in person as you could simply check breathing etc. Beats me how you think the patient not being there actually makes things quicker and easier. How does that make sense? An actual logic fail on your behalf.

It takes 9 years to train to be a GP and you are questioning a small 30 euro fee for their time. It's actually hilarious.

You might be able to hire a solicitor for about 3 minutes for 30 euro.

You've made alot of assumptions and interesting if questionable comparisons.


On the 9 years to be a GP thing though and questioning a 30 euro fee. That is an outrageously deceptive way to characterise the discussion. Clearly this is 30 on top of the dozens of other fees (amounting to some 500m+) already received.

Further it is at a time when their private patient numbers have apparently fallen off a cliff.

Again on that specific point, if you always characterised such discussions on the "just give it to them, they trained for 9 years" line then where would it end?

Balf

Bubbaclaus wrote: »

You might be able to hire a solicitor for about 3 minutes for 30 euro.

You regard the legal profession as the benchmark?

In fairness, the IMO must wonder how you get away with it.

But I sense we're on the verge of a discussion that will take us far from covid 19.

noodler

Bubbaclaus wrote: »

How much would you value 10-15 minutes of a doctors time to be? Just curious.

I paid 60 for a three minute consultation last week.

Obviously that was a quick one.

But obviously, and I know you aren't, it would be mad to suggest 20 euro a minute.

Bubbaclaus

noodler wrote: »

You've made alot of assumptions and interesting if questionable comparisons.


On the 9 years to be a GP thing though and questioning a 30 euro fee. That is an outrageously deceptive way to characterise the discussion. Clearly this is 30 on top of the dozens of other fees (amounting to some 500m+) already received.

Further it is at a time when their private patient numbers have apparently fallen off a cliff.

Again on that specific point, if you always characterised such discussions on the "just give it to them, they trained for 9 years" line then where would it end?

What do you do for a living? I wouldn't value any skilled workers time as being worth less than 30 euro for 10-15 minutes, regardless of whether they are a doctor, solicitor, IT specialist, etc.

Seems odd to me that you don't find value in the work of medical professionals to justify 30 euro?

noodler

Balf wrote: »

You regard the legal profession as the benchmark?

In fairness, the IMO must wonder how you get away with it.

But I sense we're on the verge of a discussion that will take us far from covid 19.

We are getting off the point maybe a bit.

I'll summarise and leave it there:

I do wonder if the GPs do not have the capacity to take on these phone calls given private patient income has dropped.

Maybe cardholders are going non-stop now (and calling) and this doesn't get the GP extra money.

But I'm also concious, we allocated 3bn last week for initial government wide measures, there will be a hit to the tax take, people have lost jobs etc and I wonder have we got a good deal given more cash is going to be required in other sectors.

killbillvol2

podgeandrodge wrote: »

When Ireland puts a call out for any health workers to do what they can, and Leo tells us how proud we should be.

Doctors negotiate €30 from the Exchequer PER PHONECALL to make a diagnosis.


This will cost the country a fortune.

Not justifiable IMO.

There's a simple solution. When you get the symptoms don't call your GP. You can self test and self cure.

DisneyLover

Where was this announced ? I spent 1.5 minutes on phone to my GP yesterday and was charged 60 quid. Then work consultant not happy with viral infection diagnosis so work sending swab ambulance. Still hasn't arrived waiting since 1pm yesterday.

So can I claim back 30 quid ?

Strumms

Bubbaclaus wrote: »

How much would you value 10-15 minutes of a doctors time to be? Just curious.

Value doesn’t come into it, How much would you deem it ‘necessary’ to charge the public in a time of crisis ?

Bubbaclaus

Strumms wrote: »

Value doesn’t come into it, How much would you deem it ‘necessary’ to charge the public in a time of crisis ?

I take it you are working for free then.

smurgen

I was charged 50 euro Monday from my GP's practice after a 3 minute phone conversation with a nurse in the practice.it's a private practice and I have health insurance but she literally ran though a checklist.bit steep in my opinion.

noodler

DisneyLover wrote: »

Where was this announced ? I spent 1.5 minutes on phone to my GP yesterday and was charged 60 quid. Then work consultant not happy with viral infection diagnosis so work sending swab ambulance. Still hasn't arrived waiting since 1pm yesterday.

So can I claim back 30 quid ?

Did it really only take that long?

noodler

So 30 for 1.5mins.

30 euro for 3 minutes and not even the GP himself.

I am not saying it is representative of all but some of the 15 minute + phone call claims on here look fairly pie in the sky now.

Seth Brundle

smurgen wrote: »

I was charged 50 euro Monday from my GP's practice after a 3 minute phone conversation with a nurse in the practice.it's a private practice and I have health insurance but she literally ran though a checklist.bit steep in my opinion.

...and if it somehow took an hour (for whatever reason), what cost would it have been?

ChikiChiki

Bubbaclaus wrote: »

How much would you value 10-15 minutes of a doctors time to be? Just curious.

Under normal circumstances 40 - 50 euro presenting in person.

These are not normal circumstances. People are ill, jobs are being lost, there is real hardship down the tracks. And the diagnosis is over the phone so not as much value.

It's a national call to service, doctors should make allowances for the above.

killbillvol2

If it was free every ****ing idiot with a sniffle would be clogging up the phones.

noodler

killbillvol2 wrote: »

If it was free every ****ing idiot with a sniffle would be clogging up the phones.

??

The people calling aren't being charged.

The State is.

10-10-20

colm_mcm wrote: »

How difficult is it to perform an over the phone consultation for a specific disease I wonder?

I’m not a real doctor, but 5 minutes tops?

Simplistic. This isn't a CV-19 specific phone-call, it's all and everything.
The doctors still have to write-up the interaction, note any elements which need follow-up and potentially write up a prescription.
This is an emergency measure which will operate as a front-line filter to remove ~80% of the non-CV-19 cases over the phone, of which 20% will go on for swabbing and of that 20%, 90% will be found to be not infected (by today's metric).
In a crisis you need a funnel like this which operates to keep the non-critical cases off the A&E ward and 'manages the curve'.
We cannot afford, in human lives, to fail to manage this curve - For every hundred patients over the age of 80 with CV-19, 15 do not survive.

Strumms

ChikiChiki wrote: »

Under normal circumstances 40 - 50 euro presenting in person.

These are not normal circumstances. People are ill, jobs are being lost, there is real hardship down the tracks. And the diagnosis is over the phone so not as much value.

It's a national call to service, doctors should make allowances for the above.

This ^^^ GP’s will only be worrying where their next holiday is coming from when the undertaker starts worrying if he’s enough room for the all the bodies. They need to muck in, be flexible, providing a service in a time of crisis.

DisneyLover

noodler wrote: »

Did it really only take that long?

Yep have it on my phone 1 min 46 seconds. He went through a checklist and then consultant and nurse in hospital i work in weren't happy. I've all but one of the symptoms and GP said viral Infection but now I've to wait on swab cause hospital want to be sure. I'm self isolating since sat, only left room for loo and went on walk last night 11pm for an hour to clear my head. Didn't work cause I'm still wide awake and short of breathe

DisneyLover

killbillvol2 wrote: »

If it was free every ****ing idiot with a sniffle would be clogging up the phones.

Ok that's a good point alright